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Timing of cryoballoon pulmonary vein isolation to prevent atrial fibrillation recurrence

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Journal of Interventional Cardiac Electrophysiology Aims and scope Submit manuscript

Abstract

Background

The aims of this analysis were: to evaluate the impact of timing of ablation on the rate of atrial arrhythmias recurrence, verify if the timing of ablation impact differently in patients with paroxysmal and persistent AF.

Methods

Three thousand two hundred and five patients (60.5 ± 10 years, female 28.4%%, 78.8%% paroxysmal AF) were included in the analysis. All patients underwent only cryoballoon (CB) pulmonary vein (PV) isolation during the index procedure.

Results

The mean procedure time was 102.8 ± 50 min, with a mean fluoroscopy time of 26.3 ± 49 min. Acute PV isolation was achieved in 11760/11793 (99.7%) PVs. A total of 91 (2.8%) patients experienced a procedure-related complication. During the observation period 913/3205 (28.5%) patients had at least one atrial arrhythmias episode: 28% of patients with paroxysmal AF vs 33% of patients with persistent AF. In multivariate analysis, persistent AF together with time from symptomatic AF diagnosis to ablation, female sex, and ablation time showed to be significant predictors for AF recurrence. In particular, months from first symptomatic AF episode > 18 months was a significant predictor of AF recurrence (HR = 1.23, 95% CI = 1.03—1.46, p = 0.020).

In patients with paroxysmal AF, the multivariate analysis confirmed that months from first symptomatic AF episode > 18 month was an independent predictor of AF recurrence together with age > 62 years and female sex. In patients with persistent AF, the time from persistent AF showed to be significant predictor for AF recurrence.

Conclusions

In this multicenter analysis, time from first symptomatic AF episode > 18 months was a significant predictor of AF recurrence after CB PV isolation.

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Data availability

The data underlying this article will be shared on reasonable request to the corresponding author.

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Authors and Affiliations

  1. Mediterranea Cardiocentro, Naples, Italy

    Giuseppe Stabile

  2. Anthea Hospital, Bari, Italy

    Giuseppe Stabile

  3. Clinica Montevergine, Mercogliano, AV, Italy

    Giuseppe Stabile

  4. Casa Di Cura San Michele, Maddaloni, CE, Italy

    Giuseppe Stabile

  5. ULSS 6 Euganea, Ospedale Di Camposampiero, Cittadella, Italy

    Roberto Verlato

  6. Ospedale Delle Apuane, Massa, Italy

    Giuseppe Arena

  7. Ospedale Careggi, University of Florence, Florence, Italy

    Paolo Pieragnoli

  8. Centro Cardiologico Monzino, IRCCS, Department of Electrophysiology & Cardiac Pacing, Department of Biomedical, Surgery and Dentist Sciences, University of Milan, Milan, Italy

    Claudio Tondo

  9. IRCCS Sacro Cuore Don Calabria, Negrar, Italy

    Giulio Molon

  10. Ospedale San Maurizio, Bolzano, Italy

    Massimiliano Manfrin

  11. Ospedale San Luca, Istituto Auxologico, Milan, Italy

    Giovan Battista Perego

  12. ASST San Gerardo Di Monza, Monza, Italy

    Giovanni Rovaris

  13. Policlinico Casilino, Rome, Italy

    Luigi Sciarra

  14. Istituto Sant’Ambrogio, Milan, Italy

    Massimo Mantica

  15. ASST, Vimercate, Italy

    Riccardo Sacchi

  16. Azienda Ospedaliera Poma, Mantua, Italy

    Daniele Nicolis

  17. Maria Cecilia Hospital, GVM Care&Research, Cotignola, Italy

    Saverio Iacopino

Authors
  1. Giuseppe Stabile
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  2. Roberto Verlato
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  3. Giuseppe Arena
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  4. Paolo Pieragnoli
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  5. Claudio Tondo
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  6. Giulio Molon
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  7. Massimiliano Manfrin
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  8. Giovan Battista Perego
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  9. Giovanni Rovaris
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  10. Luigi Sciarra
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  11. Massimo Mantica
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  12. Riccardo Sacchi
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  13. Daniele Nicolis
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  14. Saverio Iacopino
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Corresponding author

Correspondence to Giuseppe Stabile.

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Disclosures

Giuseppe Stabile and Roberto Verlato received modest consultancy and speaker’s fees from Medtronic. Giulio Molon received modest consultancy fees from Medtronic and Boston Scientific and speaker’s fees from Medtronic, Boston Scientific, St. Jude, and Boehringer Ingelheim. Claudio Tondo serves as a member of Medtronic European Advisory Board and Boston Scientific International Advisory Board. He received lecture and proctor fees from Medtronic, Abbott Medical, Biosense Webster, and Boston Scientific. All other authors have reported that they have no relationships relevant to the contents of this manuscript to disclose.

Ethical approval

The project was approved by each site’s Medical Ethics Committee or Medical Director and conforms to the principles outlined in the Declaration of Helsinki.

Informed consent

Each patient provided informed consent for data collection and analysis.

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Stabile, G., Verlato, R., Arena, G. et al. Timing of cryoballoon pulmonary vein isolation to prevent atrial fibrillation recurrence. J Interv Card Electrophysiol 67, 609–616 (2024). https://doi.org/10.1007/s10840-023-01636-3

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  • DOI: https://doi.org/10.1007/s10840-023-01636-3

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